BUPRENORPHINE vs. METADONE IN THE TREATMENT OF OPIOID USE DISORDER DURING PREGNANCY

Abstract

Introduction: Opioid withdrawal is an important clinical syndrome that can cause considerable discomfort. Although considered non-life-threatening, the clinical manifestations of opioid withdrawal can lead to severe fluid loss and electrolyte abnormalities that result in hemodynamic instability and death. Objectives: to evaluate the efficacy and safety of buprenorphine and methadone in the treatment of opioid use disorder in pregnant women and to analyze which medication is superior. Materials and methods: This is an integrative review, in which the guiding question was “Is buprenorphine superior to methadone in the treatment of opioid use disorder in pregnant women?” The search for articles took place in PubMed using the terms “buprenorphine”, “methadone”, “treatment”, “opioid use disorder” and “pregnancy”, combined using Boolean operators. Results and discussion: Opioid use during pregnancy is associated with a number of adverse pregnancy outcomes, including maternal death at birth, intrauterine growth restriction, placental abruption, preterm labor, oligohydramnios, stillbirth, premature rupture of membranes and cesarean delivery when compared with no opioids. Compared to babies exposed to buprenorphine, babies exposed to methadone had a statistically significant increased risk of neonatal abstinence syndrome. Conclusion: Based on our research, buprenorphine and methadone are equally effective and safe in the treatment of opioid use disorder, however, buprenorphine has been shown to be safer for newborns in relation to neonatal abstinence syndrome.